anndor

Hi all What sort of debriefing for staff do your units offer, and what do you find effective? We tend to have runs of deaths, or particularly distressing cases, then quiet periods, which makes formal debriefing difficult to organise. Some staff let management know that they feel unsupported during difficult times, but when debriefing sessions are set up, they are generally poorly attended, partly because people don't want to come in on their days off, which is fair enough. Any wonderful ideas out there?

We have relatively good ECMO results, as we are very choosey about who goes on. We do both adult and paed patients, and the circuit is nearly always run by an ECMO nurse specialist with perfusion back-up (on call). The patient is cared for by an RN, who has very little to do with the circuit. The two nurses have quite seperate roles. We don't have RTs at our hospital. The patients who have the best results are neonates with meconium aspiration. Our cardiac kids do fairly well, too. Adults with overwhelming pneumonias do best as adults. We haven't had good results with lung transplants on ECMO.

I'm not sure how long post-op this works, but any child that is prone to JET (Junctional ectopic tachycardia), we cool to between 35 - 36 Celcius. They need to be sedated and paralysed for this. We also block them completely with Amiodarone 25 mcg/kg/min for 4 hours, then 15 mcg/kg/min. We would then pace them at a rate faster than their intrinsic rate. I guess your next port of call would be ablation in the cath lab. Good luck!

Hello girloutnumbered! See you Monday night shift for our last duty together!